Gastroenterology

Neil Wagner

According to doctors from UCLA Medical Center, people aren't taking heartburn seriously enough. Anyone who is experiencing heartburn at least once a week has got a serious medical problem and should seek medical attention.

The rate of esophageal cancer has soared, increasing six-fold between 1976 and 2001. And it's probably not a coincidence that the number of heartburn sufferers has also spiked in that time period.

Does untreated heartburn cause esophageal cancer? It can. Years of stomach acid washing into the esophagus can cause an inflammation in its tissue lining, a condition called Barrett's esophagus. People with Barrett's esophagus are at much higher risk for esophageal cancer, possibly forty times higher.

Esophageal cancer can be treated if caught early, but the survival rate is low. The American Cancer Society estimates that there will be 17,500 new cases of esophageal cancer in the U.S. in 2012, and more than 15,000 deaths from the disease. Complicating matters is the fact that people with esophageal cancer may not experience symptoms other than heartburn.

"Early identification, treatment and management of changes in the esophageal lining are critical to catching problems early," says Dr. Kevin Ghasemi, clinical programs director at the UCLA Center for Esophageal Disorders.

Heartburn occurs when stomach acid makes its way up the esophagus, the tube that connects the mouth to the stomach. This is sometimes called acid reflux. When this keeps happening, it's usually called gastrointestinal reflux disorder (GERD). For details, see "More than a Little Heartburn: Gastro-Esophageal Reflux Disease (GERD)."

The most common symptoms of heartburn are a burning sensation in the chest that may spread to the throat, a sour taste in the back of the mouth, or both.

While there's no proof that the surge in esophageal cancer is due to the surge in GERD, it's certainly suspicious. But there is plenty of proof that stomach acid belongs in the stomach. When it gets out, irritation and inflammation will follow, and long-term inflammation anywhere in the body is never good. People whose stomach acid won't stay put would be much better off if it did. And it can, because heartburn is usually preventable.

Repeated heartburn can be caused by metabolic disorders, but more often it's caused by lifestyle, and lifestyle changes are usually the best way to prevent it. If these fail, there are medications available. UCLA doctors offer several tips for preventing heartburn and suggestions about what to do when heartburn will not go away.

To help prevent heartburn:

• Don't overeat. This is probably the number one cause of heartburn. And don't lie down immediately after eating. It makes it easier for stomach acid to move upwards.
• Lose extra pounds. Added weight adds to heartburn.
• Don't smoke. And avoid or minimize caffeine, alcohol and fatty foods.
• Consider light exercise, such as walking, after eating. This improves digestion
• Wear loose fitting clothes

For people who've been living with heartburn:

• If you're experiencing heartburn every week or more often, see your doctor and get started treating the condition.
• If you've been prescribed heartburn medications, remember to take them regularly
• Certain heart and blood pressure medicines such as calcium channel blockers and nitrates can increase the chance of acid reflux and worsen heartburn symptoms. If you're taking these medications and have heartburn, discuss the possibility of switching to an alternate medication with your doctor.
• White men aged 50 or older who've been experiencing heartburn for 10-15 years should consider getting screened for esophageal cancer.

For more information, see the July 16, 2012 news release from the UCLA Health Sciences.